Health systems and older populations

A report titled “Decade of Healthy Ageing” by the World Health Organisation (WHO) included useful insights into the status of the world’s older populations and what health authorities and policymakers and international development partners could do in order to ensure this group of people is not left behind.
According to the report, at least 14 per cent of all people aged 60 years and over – more than 142 million people – are currently unable to meet all their basic daily needs. The report brings together data available for measuring healthy ageing, defined by WHO as “the process of developing and maintaining the functional ability that enables well-being in older age”.
WHO Director General, Dr Tedros Adhanom Ghebreyesus notes that humans now live longer than at any other time in history. “But adding more years to life can be a mixed blessing if it is not accompanied by adding more life to years.”
He said that the Baseline Report for the Decade of Healthy Ageing has the potential to transform the way policymakers and multiple service providers engage with older adults. The report also discusses what is needed to promote collaboration and better measured progress towards healthy ageing.
WHO says that optimising “functional ability” is the goal of the Decade of Healthy Ageing, which began in 2021 and addresses five interrelated abilities that all older people should enjoy: the ability to meet basic needs, to continue to learn and make decisions, to be mobile, to build and maintain relationships, and to contribute to society.
The Baseline Report presents the experience of countries which have been successful in starting healthy ageing initiatives in each of these areas, such as Ireland, Mexico and Vietnam. It also stresses that older adults must be engaged throughout.
According to the report, only one-quarter of countries around the world are compiling comparable data which can be used to monitor global progress towards healthy ageing. Some countries that are collecting and using data to improve policies and programmes for and with older persons are presented in the report. These countries are Chile, China, Finland, Ghana, India, Qatar, Singapore, and Thailand.
A number of indicators to be reported on by countries as a demonstration of commitment towards healthy ageing were agreed on by WHO Member States as part of the Global Strategy on Ageing and Health 2016-2020 and endorsed in 2020 within the context of the Decade for Healthy Ageing 2021-2030. Examples are the establishment of a national committee or forum on ageing, comprehensive assessments of the health and social care needs of older people, and a policy on strengthening long-term care.
It should be stated that the Caribbean has been recognised as having one of the fastest-growing older populations in the developing world. This certainly poses its own challenges, and Governments and other actors will be required to take the necessary measures to ensure that this segment of the population lead healthier and more productive lives.
There is no doubt that among the more pressing issues affecting older persons are health concerns and the quality of care being provided to them on a daily basis. It is, therefore, crucial for Governments to put systems in place which would allow for older persons to obtain the health services they need.
WHO’s new Guidelines on Integrated Care for Older People recommend ways community-based services can help prevent, slow, or reverse declines in physical and mental capacities among older people. The guidelines also require health and social care providers to coordinate their services around the needs of older people through approaches such as comprehensive assessment and care plans.
Director of the Department of Ageing and Life Course at WHO, Dr John Beard had previously noted that older adults are more likely to experience chronic conditions and often multiple conditions at the same time. Yet today’s health systems generally focus on the detection and treatment of individual acute diseases.
He had reasoned that if health systems are to meet the needs of older populations, they must provide ongoing care focused on the issues that matter to older people – chronic pain, and difficulties with hearing, seeing, walking or performing daily activities. On this basis, he noted that this required much better integration between care providers.
The health authorities in Guyana may want to give serious consideration to recommendations presented by WHO.